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Back Ground: The present study was undertaken to compare is to find out the nature and the extent of radial artery complications by high-resolution vascular ultrasound after transradial diagnostic angiography and percutaneous transradial interventions (PCI) with 5F and 6F vascular sheaths. Methods: A total of 461 patients who are undergoing CAG, PCI through trans radial access with 5- F(n=192), 6-F(n=366)sheaths were studied. Duplex sonography was obtained in each patient before and after discharge and after 1 month those who had Radial Artery Occlusion (RAO). Results: The radial artery occlusion after coronary angiogram with ultrasound was observed in 26 cases (5.64%). out of which the rate of RAO in 5F sheath group was 10 (5.25%) and in 6F sheath group was 16 (4.37%, p=0.34). On univariate analysis the predictors of post procedural RAO were sex (p<0.032), operator 1 (p<0.034). There was no statistically significant difference between 5 and 6 French sheaths (p=0.34). In multivariate regression analysis all of our results remained unchanged.18 patients out of 28 (who presented with RAO) had severe symptoms and were treated with Low Molecular Weight Heparin (LMWX) for 7-14 days. On follow up after one month none of these patients have re-canalization of the artery. 10 patients who had RAO with no symptoms showed spontaneous re-canalization of the artery on follow up. Conclusion: The rate of RAO by ultrasound examination is less in this study as compared to previous studies. The use of 5–F sheath for transradial access does not significantly decrease the rate of RAO when compared with 6-F sheath.